Provider Demographics
NPI:1477834075
Name:HOOVER, TAYLOR HARDEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:HARDEN
Last Name:HOOVER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-1806
Mailing Address - Country:US
Mailing Address - Phone:502-223-1303
Mailing Address - Fax:502-223-1126
Practice Address - Street 1:206 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-1806
Practice Address - Country:US
Practice Address - Phone:502-223-1303
Practice Address - Fax:502-223-1126
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY60201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice